[2040 Roadmap] Explaining the New 'Regional Medical Care Vision Formulation Guidelines'! Summary of Changes and Key Tasks
[2026 Latest] A Thorough Explanation of the 2040 'New Regional Medical Care Vision' | Changes to Formulation Guidelines, Roadmap, and Responses for Medical Institutions
The Ministry of Health, Labour and Welfare has released the **'New Regional Medical Care Vision Formulation Guidelines'** with an eye toward 2040.
The previous regional medical care vision had '2025,' when the baby boomer generation turns 75 or older, as a primary goal, and mainly promoted the functional differentiation and coordination of inpatient beds.
However, looking toward 2040, the environment surrounding regional medical care delivery systems will change significantly, such as with the increase in the elderly population aged 85 and over and the decline in the working-age population.
Therefore, in the new regional medical care vision, initiatives will be advanced with a view toward the entire regional medical care delivery system, including outpatient care, home medical care, coordination with nursing care, and human resource retention, not just hospital beds.
In this article, we will organize the professional content as clearly as possible, focusing on the following points regarding the new regional medical care vision:
What will change toward 2040?
What is 'comprehensive function'?
How will the calculation method for the required number of hospital beds change?
How will 'acute care hub functions' be secured?
What is the roadmap toward 2040?
By when and what must medical institutions and prefectures do?
What are the remaining unresolved issues?
We will organize these points to make the professional content as easy to understand as possible.
Table of Contents
Background and Purpose of the 'New Regional Medical Care Vision' for 2040
What Changes in the New Regional Medical Care Vision? 3 Key Points
Roadmap and Key Tasks toward 2040
Future Considerations and Unresolved Issues
[FAQ] Frequently Asked Questions about the New Regional Medical Care Vision
Summary | How will regional medical care change toward 2040?
1. Background and Purpose of the 'New Regional Medical Care Vision' for 2040
Japan's medical care delivery system is facing a major turning point.
Until now, the focus has been on '2025,' when the baby boomer generation will be 75 or older, with efforts made toward functional differentiation and coordination of hospital beds.
However, aging and population decline will continue beyond 2025.
In particular, toward 2040, responses to different challenges than before will be required regarding regional population structures, medical demand, and securing medical personnel.
What will change toward 2040?
There are two major points:
1. Medical and nursing care needs will become complex
As the population of those 85 and older increases, demand for emergency care for the elderly and home medical care will rise, while demand for acute care will decrease in many regions.
In other words, the medical functions required will change depending on the region.
2. Securing medical personnel will become more difficult
With the decline in the working-age population, it will become increasingly difficult to secure medical personnel such as doctors, nurses, and pharmacists.
Therefore, it is important not only to adjust the number of hospital beds but also to consider how to utilize limited medical resources across the entire region.
The major goal of the new regional medical care vision is to respond to these 'differences in regional population structures and medical resources' and build a 'region-complete' medical and nursing care delivery system where all generations can live with peace of mind.
2. What changes with the new regional medical care vision? 3 key points
There are changes in the new regional medical care vision that you should especially keep in mind.
Here, we have organized them into the following three points:
Introduction of 'Comprehensive Functions'
Change in the hospital bed occupancy rate used to calculate the required number of hospital beds
Securing 'Acute Care Hub Functions'
1. Introduction of 'Comprehensive Care Functions'
One of the major changes this time is the introduction of **'Comprehensive Care Functions'.
In the conventional hospital bed functions, 'convalescent care functions' were positioned.
In the new regional medical care vision, regarding convalescent care functions,
Providing treatment
Providing rehabilitation, etc., from the early stages of hospitalization
Aiming for early return to home
These functions, which provide 'medical care that cures and supports,' combined with conventional convalescent care functions, are positioned as **'Comprehensive Care Functions'.
In other words, it is important that it is organized not just as 'hospital beds for recovery,' but as a function that considers everything from treatment to rehabilitation and return to home.
2. The 'Bed Occupancy Rate' used to calculate the required number of hospital beds will change
When calculating the required number of hospital beds, the bed occupancy rate is an important factor.
In the new regional medical care vision, the bed occupancy rate parameter used to calculate the required number of hospital beds will be revised, taking into account the actual decline in bed utilization rates and the **'certain margin'** required to respond to emerging infectious diseases, etc.
The set bed occupancy rates are as follows.
Furthermore, based on efficiency improvements through medical DX initiatives and smoother admission and discharge processes, etc.,
Highly Acute/Acute: +1%
Comprehensive Care: +2%
Chronic Care: +0.5%
efficiency gains are expected to be factored in.
The point is to consider the required number of hospital beds by also taking into account the actual medical care provision system and efficiency improvements rather than just looking at the number of hospital beds.
(3) Securing 'Acute Care Hub Functions'
Another important point is the "acute care hub function".
This is positioned as a function to consolidate cases such as surgeries and emergency medical care to ensure the quality of medical care while realizing sustainable working styles.
The guideline for securing these is
approximately one location per 200,000 to 300,000 people
.
However, in regions with smaller populations, consideration will be given to expanding the scope of the vision area or coordinating across prefectural borders.
In other words, it is also important to consider consolidating necessary medical functions and coordinating between regions, rather than trying to complete all medical functions within each individual region.
3. Roadmap and Key Tasks Toward 2040
The new regional medical care vision is required to beformulated by the end of fiscal year 2028.
Toward 2040, prefectures, medical institutions, and regional medical care vision coordination meetings will proceed with preparations while fulfilling their respective roles.
The main tasks are summarized as follows.
The '2028 Fiscal Year' is particularly important
One major milestone in the new regional medical care vision isfiscal year 2028.
Each medical institution will examine the functions it plans to perform in 2040, and after discussions at regional medical care vision coordination meetings, a new regional medical care vision will be formulated.
Following that, around fiscal year 2029, this will lead to the formulation of the 9th Medical Care Plan.
4. Future Considerations and Unresolved Issues
While the new guidelines have indicated a direction, there are also issues that will require more concrete consideration in the future.
(1) Regional Medical Care Vision for Psychiatric Care
With the revised Medical Care Act, psychiatric care has been incorporated into the regional medical care vision.
On the other hand, regarding the specific details, discussions will begin after the government formulates the guidelines, which is expected by the end of fiscal year 2026.
(2) Securing medical personnel other than doctors
Securing not only doctors but also nursing staff, pharmacists, and others is an important issue.
Efforts regarding training and securing personnel are currently being studied by the government, including supply and demand projections.
Based on that situation, it will be necessary to conduct future discussions, including at the consultation forums.
(3) Home medical care zones and the role of hubs
Home medical care also requires further concretization in the future.
In particular, it is necessary to further organize the specific definitions and roles regarding:
'Home medical care zones' that harmonize with the vision areas
'Medical institutions that play an active role'
'Hubs that handle coordination'
as mentioned above.
(4) The ideal state of critical care centers
In areas with declining populations, how to maintain the functions of critical care centers is also an issue.
Should the functions as a critical care center be maintained, or should the system transition to one centered on secondary emergency care?
Continuous discussions will proceed toward the 9th Medical Care Plan.
5. [FAQ] Frequently Asked Questions about the New Regional Medical Care Vision
Q1. What is the difference between the conventional regional medical care vision and the new 2040 regional medical care vision?
A. A major difference is that it covers the entire regional medical care delivery system, not just the functional differentiation and coordination of hospital beds.
The conventional regional medical care vision, which aimed for 2025, focused mainly on the 'functional differentiation and coordination of inpatient beds'.
Meanwhile, the new regional medical care vision for 2040 is positioned as a higher-level concept for medical planning, covering not just hospital beds, but also
outpatient care
home medical care
coordination with nursing care
securing human resources
and more, targeting the entire regional medical care delivery system.
Q2. By when do medical institutions need to decide their own functions?
A. They must make a final decision and report it by the end of fiscal year 2028 at the latest.
Each medical institution will consider its own role and report the functions it plans to fulfill in 2040 in its medical institution function report.
After that, discussions based on objective data will be held at the regional medical care vision coordination meeting.
Then, a final decision must be made and reported by the end of fiscal year 2028 at the latest.
Q3. How will bed reporting change with the introduction of 'comprehensive functions'?
A. Conventional convalescent functions will be reorganized, and 'comprehensive functions' will be established to support everything from treatment and rehabilitation to returning home.
Medical institutions will objectively judge and report their bed functions based on the actual state of medical care provided, while using regional general inpatient fees and convalescent rehabilitation ward inpatient fees under the medical fee schedule as a guide.
6. Summary | How will regional medical care change toward 2040?
The new regional medical care vision for 2040 is an important roadmap for building a sustainable medical care delivery system in Japan, where the declining birthrate, aging population, and shrinking working-age population are progressing.
The key points of this update are summarized as follows.
Key points of the new regional medical care vision
1. Introduction of 'comprehensive functions'
We will reorganize conventional convalescent functions and position them alongside 'healing and supporting medical care,' which aims for treatment, rehabilitation from the early stages of hospitalization, and early return to home.
② Review the calculation method for the required number of hospital beds
Regarding hospital bed occupancy rates, we will set them at 78% for highly acute care, 83% for acute care, 87% for comprehensive care, and 92% for chronic care, while also accounting for efficiency gains.
③ Secure acute care hub functions
Regarding acute care hub functions that consolidate surgery, emergency medical care, etc., we will aim to secure approximately one location per 200,000 to 300,000 people.
④ Fiscal year 2028 is a major milestone
Each medical institution will consider the functions it will perform in 2040, and each prefecture will formulate a new regional medical care vision by the end of fiscal year 2028.
⑤ Toward the 9th Medical Care Plan around fiscal year 2029
Based on the new regional medical care vision, this will lead to the formulation of the 9th Medical Care Plan as a concrete implementation plan.
Looking toward 2040, for regional medical care, the perspective of not just 'what to do with hospital beds' but rather how to secure the necessary medical functions for the region and how to combine limited medical resources will become increasingly important.
Moving forward, each region will proceed with data analysis, inspection and review of medical care zones, and consideration of the functions to be performed by medical institutions.
When thinking about regional medical care in 2040, it is important to view it as a roadmap that includes not only 'what will be decided by fiscal year 2028' but also 'how those decisions will connect to 2030, 2035, and 2036' is crucial.
We will continue to organize the key points of regional medical care visions, medical service fees, and medical policies as clearly as possible while following the materials and institutional movements of the Ministry of Health, Labour and Welfare.
Source: Regional Medical Care Vision Formulation Guidelines
Thank you for reading until the end.
In this note, I continuously organize and explain medical policies based on primary sources.
I will share information not only on one-off news and notifications but also by tracking notifications, interpretations of doubts, and practical responses, connecting the dots so that you can understand the flow of the system.
I also summarized an article when the 'Draft Summary of the New Regional Medical Care Vision' was presented at the Ministry of Health, Labour and Welfare's 'Study Group on Regional Medical Care Visions and Medical Care Plans'.
In that, the government decided to formulate new 'Regional Medical Care Vision Formulation Guidelines' based on the revised Medical Care Act.
Now that these 'Regional Medical Care Vision Formulation Guidelines' have been published, I have reorganized the content and summarized it in this article.
Medical policy and medical fee revisions have many foreshadowings that lead to months and years ahead. If you want to continuously follow the flow of changes, please be sure to follow.
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